Craig Kent says that academic health systems sit at the intersection of multiple missions, including education, research, and patient care, making their governance uniquely complex. This uniqueness is unlike nonacademic health systems, where the focus is only on clinical care, or universities without a health system, where the focus is limited to education and research. Academic Health Systems must balance all three missions (clinical operations, research, and education) while maintaining the financial sustainability of an operation that is often significantly larger than that of the parent university. In this context, the composition of the board of directors plays a decisive role in ensuring long-term stability and operational excellence. A healthcare-focused board is not just advantageous; it is essential.
Understanding the Unique Challenges of Academic Health Systems
Academic health systems face pressures that are distinct from other healthcare organizations. They must navigate the demands of a teaching hospital, manage large-scale research initiatives, and deliver high-quality care to the most complex of patients. Each of these domains comes with regulatory, financial, and operational complexities. Without governance informed by healthcare-specific expertise, boards of AMCs risk making decisions that overlook critical nuances, potentially jeopardizing both patient care and the success of the academic missions, as well as institutional reputation.
The Importance of Healthcare Expertise on the Board
Boards with a strong understanding of healthcare and the academic missions associated with healthcare are better positioned to evaluate clinical and operational risks, understand the nuances of healthcare education and research, and align strategic initiatives with enhancements in patient care. Healthcare-focused board members bring insight into regulatory compliance, quality metrics, and industry trends, which are often outside the scope of governance of a university. Their expertise allows boards to make informed decisions about investments, partnerships, innovation strategies, and growth and M&A, ensuring that the system can thrive in an increasingly complex healthcare environment.
Strategic Decision-Making and Risk Management
Craig Kent explains that healthcare-focused boards provide a critical lens for assessing risk. Academic health systems often face uncertainties related to funding, technological adoption, supply chain, external competition, and clinical quality. Board members with clinical or operational experience can anticipate these challenges, evaluate strategic alternatives, and implement governance structures that protect both the institution and its patients. This proactive approach strengthens financial stability and operational resilience, reducing the likelihood of costly missteps.
Supporting Mission-Driven Growth
A healthcare-focused board is uniquely equipped to champion the mission of an academic health system. Whether it’s expanding clinical services, enhancing research programs, or improving medical education, these board members understand how each initiative interconnects with patient care and long-term sustainability. Their insight ensures that growth strategies are not only ambitious but also realistic and aligned with the system’s core objectives.
Conclusion
Craig Kent suggests that the stability and potential of an academic health system are inseparable from the expertise and vision of its governing board. While diverse perspectives are valuable, the inclusion of healthcare-focused board members is indispensable. The knowledge and experience of the board in clinical operations, quality and patient service, risk management, strategic planning, healthcare M&A, and so much more, provide the necessary guidance to navigate the complexities of modern healthcare, which continues to evolve at a rapid pace. A widely acknowledged sentiment in the modern healthcare industry, reflecting the rapid and relentless pace of change, is “If you are not moving forward, you’re moving backward.” By prioritizing healthcare expertise at the board level, academic health systems can safeguard their mission, maintain operational stability, and continue delivering excellence in their core missions of patient care, research, and education.

